CDC: 1 in 5 U.S. Workers Use Tobacco Products

Construction, food-service workers most likely to smoke cigarettes

Close to 33 million working adults in the United States -- or roughly 20% -- regularly smoke cigarettes, vape, or use some other tobacco product, the CDC reported.

Just over 15.4% of working adults reported smoking cigarettes, while 5.8% used another combustible tobacco product, 3% used a smokeless tobacco product, and 3.6% used e-cigarettes, according to the analysis of 2014-2016 data from the National Health Interview Survey (NHIS), published Thursday in the CDC's Morbidity and Mortality Weekly Report.

Construction workers and repair/installation/maintenance workers had the highest overall tobacco use by occupation (34.3% and 37.2%, respectively). For cigarette smoking in particular, the highest rates were among construction workers and food/accommodation industry workers (24% and 25.8%, respectively).

Physical and social science workers had the lowest tobacco use by occupation (9.3%), followed by educators/librarians (9.5%), and healthcare workers (11.7%).

"We had previously shown significant disparities in tobacco prevalence among U.S. workers," said Girija Syamlal, MBBS, of the National Institute for Occupational Safety and Health (NIOSH) Respiratory Health Division.

"We also know that smoke free workplace policies and interventions have been effective in reducing occupational cigarette smoke and second-hand smoke exposures," she told MedPage Today.

Cigarette smoking has declined to record low levels among adults in recent years, but the report made clear that rates vary substantially among occupations.

The nationally representative NHIS for 2014-2016 defined current cigarette smokers as having smoked 100 or more cigarettes during their lifetime and reporting currently smoking "every day" or "some days." Other combustible tobacco products included cigars, pipes, water pipes or hookahs, small cigars and bidis.

Current smokeless product use (including chewing tobacco, snuff, dip, snus, or dissolvable tobacco) was defined as using the products at least once in a lifetime and currently using "every day" or "some days." Current e-cigarette users included those who reported using e-cigarettes at least once and were currently using them "every day" or "some days."

Current use of two or more tobacco products were classified as multiple tobacco use.

Among the main findings from the combined 2014-2015 survey results:

22.1% of employed adult survey respondents reported current use of any tobacco product

4.6% of tobacco users reported use of two or more tobacco products

Current tobacco use was highest among men (27.4%), non-Hispanic whites (24.8%), young adults (24.9%), those with a high school education or less (30.1%), those with no health insurance (33.9%), and people living below the federal poverty line (28.5%)

By occupation, e-cigarette use was highest among food service/accommodation industry workers (5.8%) and repair/installation/maintenance workers (7.9%)

"Workplace tobacco-control interventions have been especially effective in reducing cigarette smoking prevalence," the researchers wrote. "Previous research has indicated that workers at worksites that adopted or maintained smoke-free policies were twice as likely to quit smoking than those whose worksites did not implement such policies."

They conclude that employers should consider including comprehensive tobacco cessation programs as part of their workplace health promotion efforts.

Study limitations cited by the researchers included the self-reporting of tobacco use, which could have led to underreporting or over-reporting, and a small number of respondents for certain occupations.

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